We hear a lot of reports about the growing obesity epidemic, but what does it mean? 
What are the costs?  How did it happen?

Obesity is defined as a body-mass index (BMI) of 30 or higher.   Interestingly, the rate of obesity is not equally distributed around the U.S.  Check to see how your state lines up in the prevalence of obesity:

The World Obesity Epidemic

I know it may be hard to believe, but the U.S. isn’t the most ‘obese’ country on earth.  In fact, we’re also not the most ‘overweight’ (defined as a BMI of 25-29.9).  Have we yet ‘hit the ceiling?’ After a quarter-century rise, obesity prevalence has not increased since 2004.  Still, 72 million adults (34%) are obese. Many health professionals would like this number to be less than 15%, a level not seen since 1980. Below are the top eight ‘obese’ countries and the top eight ‘overweight’ countries:

Where Do You Fit In?  What’s Your BMI?

Underweight = <18.5
Normal weight = 18.5-24.9
Overweight = 25-29.9
Obesity = BMI of 30 or greater

Counting Calories

Obesity rates in Americans ages 12 - 19 have more than tripled since 1980! Not only are we consuming too much fast food, processed white foods and drinking too many liquid calories, but we are also way too sedentary.  It only takes an extra 100 calories daily to manifest to a ten-pound weight gain in one year. That’s not that much food (maybe a couple of Oreos with some nonfat milk).  Instead of, “Where’s the Beef?”  How about, ‘Where’s the Fruits and Vegetables?’ It is our own responsibility to ‘provide’ and ‘enforce’ healthy eating principles.  Adults need to eat right and expect the same of their children.  Keeping a food record for a few days can be a real eye-opener to how many extra calories you (or your child) are consuming each day.

Children should consume around 1,300 calories a day, or about 430 calories per meal (on average).  One typical kid’s meal provides 570 to 740 calories per meal.  These extra calories are very cumulative and can really add up and contribute to the obesity epidemic in children and adults.

The USDA recommends the average adult consume only 2,000 calories daily. The average American adult consumes from 1,883 up to 5,649 calories daily, as estimated by the World Health Organization.  It is also estimated that over 40% of our calorie intake comes from both fat and excessive sugar intake of any form (corn syrup, molasses, honey, high-fructose corn syrup, maltodextrin, etc.).  What this means is that we are eating more calories, 24% more to be exact.  Although, there has been some finger pointing, one single food group is not to blame.  It’s the big picture of too many calories (regardless of sugar or fat content) and not enough exercise.

The Personal Cost Of Fat

• Trouble At Work – Obese workers cost employers more in medical, disability, and workers’ compensation claims.
• The Bill – The average firm with 1,000 employees faces $285,000 per year in extra costs associated with obesity.
• Discrimination – In 1996 only 7% of American adults reported weight discrimination as compared to 12% in 2006.
• The Hidden Toll

What Can We Do About It?

The likelihood of developing Type 2 diabetes and hypertension rises steeply with increasing body fat. Confined to older adults for most of the 20th century, this disease now affects both moderately overweight and obese children even before puberty. Approximately 85% of people with diabetes are type 2, and of these, 90% are obese or overweight.

Effective weight management for adults and children at risk of becoming overweight and developing obesity involves a range of long-term strategies. These strategies include:

• Nutrition and Lifestyle Changes
• Food-Nutrient Timing and Portions Sizes
• Diagnosis-Specific Nutrition Education
• Physical Activity Education/Monitoring
• Laboratory Assessment/Target Ranges
• Nutrient Supplementation
• Stimulus Control/Behavior Barriers
• Personal Goal Setting
• Self Monitoring via Food Record Keeping

Meeting with a Registered Dietitian can and should be part of a ‘face-to-face’ personalized nutrition education and awareness-based approach, which includes family and environmental support for healthier eating and regular physical activity.  Ask your Sound Family Medicine physician if he/she thinks you are an appropriate patient to benefit from Medical Nutrition Therapy (a physician referral is usually warranted by insurance).

Brooke Douglas, R.D., C.D.
www.NutritionAuthority.com